Music may be alternative to drug used to calm pre-op nerves

They said music seemed to have similar effects as midazolam in reducing anxiety before a peripheral nerve block – a type of anaesthetic procedure designed to numb a specific region of the body.

“Music medicine may be offered as an alternative to midazolam administration”

Study authors

The researchers, from the University of Pennsylvania, noted that pre-operative anxiety was common and could raise levels of stress hormones in the body, which in turn affected recovery after surgery.

They highlighted that such anxiety was usually treated with benzodiazepines, such as midazolam, but these drugs had side effects and also required continuous monitoring by a skilled clinician.

While music has been used to lower pre-operative anxiety before, the researchers said it had not previously been directly compared with intravenous midazolam.

Writing in the journal Regional Anesthesia & Pain Medicine, they said they wanted to find out if it might offer a suitable alternative to midazolam to calm the nerves before a peripheral nerve block.

They randomly assigned 157 adults to receive either 1-2mg of midazolam, injected three minutes before the use of a peripheral nerve block, or to listen to a piece of music via noise cancelling headphones for the same period.

The piece of music chosen was Marconi Union’s Weightless series of music, which is considered to be one of the world’s most relaxing songs.

Back in October 2011, Manchester trio Marconi Union worked with the British Academy of Sound Therapy to specially create the soothing tune.

The eight-minute song features guitar, piano and manipulated field recordings. It is punctuated throughout by low tones that supposedly induce a trance-like state.

Previous surveys of small numbers of people have suggested it is more relaxing than songs by Enya, Mozart and Coldplay, or even more relaxing than a massage, walk or cup of tea.

In the new study, levels of anxiety were scored using a validated measure (State Trait Anxiety Inventory-6, or STAI-6 for short) before and after the use of each anxiety calming method.

Satisfaction among patients and clinicians were scored on a 10-point scale, with zero reflecting the lowest level of satisfaction.

Changes in the levels of pre-operative anxiety were similar in both groups, according to the researchers.

However, patients in the music group were less satisfied than those given midazolam, possibly because they were not allowed to choose the music they listened to, suggested the researchers.

Meanwhile, both patients and clinicians thought it was harder to communicate when music was used to calm nerves, possibly because of the use of noise cancelling headphones.

The authors highlighted that a comparison lasting just three minutes may have been too short, but this period was chosen because that is how long it takes for midazolam to reach peak effectiveness.

Nevertheless, they said their findings had prompted them to conclude that music may be offered as an alternative to midazolam before carrying out a regional nerve block.

The researchers stated: “Music medicine may be offered as an alternative to midazolam administration prior to peripheral regional anesthesia.”

But they added: “Further studies are warranted to evaluate whether or not the type of music, as well as how it is delivered, offers advantages over midazolam that outweigh the increase in communication barriers.”